This Week in HIV Research: Antibody Suppresses HIV; Investigational Drug BMS-986001; and Quality of Care on Mortality
This week, we read early results on an antibody that suppressed HIV for a small group of individuals who are living with the virus but not on treatment. We also read results for BMS-986001, an investigational nucleoside reverse transcriptase inhibitor, and how it compares to tenofovir disoproxil fumurate (TDF, Viread). Lastly, we look at a study that analyzes how quality of HIV care affects mortality rates. To beat HIV, you have to follow the science!
Infusing a broadly neutralizing antibody known as VRC01 can help suppress HIV in people who are not on antiretroviral therapy, according to early study results published in the journal Science Translational Medicine.
The study followed 23 HIV-positive individuals. The 15 participants who were on antiretroviral therapy received two infusions of VRC01 28 days apart, and the eight participants who were not on treatment received one VRC01 infusion. The infusion, which was administered into a vein, was safe and well tolerated.
"The researchers found that while antibody infusions did not reduce the amount of HIV in blood cells, they reduced plasma viral load more than 10-fold in six of the eight people who were not on [antiretroviral therapy]," according to the study press release. Furthermore, for the two participants who had the lowest viral loads in the treatment-naive group, VRC01 suppressed HIV to extremely low levels for up to 3 weeks, or as long as therapeutic concentrations of the antibody were present.
For the participants who were on antiretroviral therapy, the VRC01 antibody did not appear to have any effect because their viral loads were already undetectable.
An novel nucleoside reverse transcriptase inhibitor (NRTI) known as BMS-986001 has similar efficacy to that of tenofovir disoproxil fumurate andsmaller decreases in bone mineral density (BMD), according to a study published in The Lancet HIV.
The study followed 297 treatment-naive patients and randomized them into four treatment groups. Each group received efavirenz (Sustiva, Stocrin) and lamivudine (3TC, Epivir) with either BMS-986001 (at 100 mg, 200 mg or 400 mg) or tenofovir at 300 mg.
At week 24, 88% of the 100-mg group, 81% of the 200-mg group, 94% of the 400-mg group achieved a viral load below 50 copies/mL, compared with 89% of the tenofovir group.
At week 48, 75% of the 100-mg group, 81% of the 200-mg group, 89% of the 400-mg group sustained a viral load below 50 copies/mL, compared with 82% of the tenofovir group.
Overall, BMS-986001 was generally well tolerated, with two participants in the groups discontinuing because of drug-related serious adverse effects compared with two participants in the tenofovir group. However, more participants in the BMS-986001 groups developed drug resistance (6% - 14%) compared to the tenofovir group (1%).
"Bristol-Myers Squibb has discontinued its involvement in the development of BMS-986001, and future decisions on development will be made by Oncolys BioPharma," the study authors note.
In the Clinic
An analysis of the Veterans Aging Cohort Study found that individuals living with HIV who received over 80% of nine HIV quality indicators (QIs) had better rates of mortality, according to a study published in Clinical Infectious Diseases.
The study analyzed data from 3,038 individuals living with HIV between June 2002 and July 2008. The participants were almost all male (97.5%) and more than half were black (66.8%), with an average age of 49 years. Overall, about 26% reported unhealthy alcohol use in the past year and around 28% reported illicit drug use in the past year.
The researchers measured quality of care based on whether the participants received nine HIV quality indicators in the year after each participant's enrollment. Those who received over 80% of QIs were associated with a higher rate of survival. However, the researchers note that the association was not sufficient enough to overcome adjustment for disease severity.